A Good Cry is What This Doctor Prescribes for the Pandemic

April 22, 2020

H. Steven Moffic, MD

“How shall the heart be reconciled
to its feast of losses? . . .”

Stanley Kunitz, from The Layers

***

In our understanding of disaster, there is usually a stage of disillusionment after an adrenaline rush to adjust. However, that rush to recover can often hover over the need to grieve all the losses, big and small.

We need to cleanse our minds to go forward as best we can, otherwise the grief can hold us back. So many report wanting to read more and extra time to do so, but they can’t. So many want to catch up to delayed cleaning, but they can’t. On the front lines, most desired is just to rest.

Brian Stelter, a commentator on CNN, recently gave his own personal example in a column titled “It’s OK to not be OK right now.” For the first time, he had missed a column deadline. Instead, he crawled into bed and cried. He concluded that those pandemic tears had been waiting a month to escape. After they escaped, he slept well and finished his column in the morning.

The problem is that generally no one likes to grieve. I mean, unless you are most masochistic, who wants to lose something important and acknowledge the shock and sadness? It’s painful. And who wants to feel that psychological pain? No wonder that religious eulogies seem to be virtually positive. So, you may not want to read further if you’ve read this far, but please do; it will explain why you may need this prescription.

Maybe you remember how bad cough medicine tasted when you were a child, but your mother insisted it would help to get rid of your cough. And it often did. So too can crying help get someone over psychological loss.

Unless mental health caregivers are working on an inpatient ward or emergency room, they have lost the possibility of live interaction with patients. As much of value as telepsychiatry seems to be as an alternative, there can be some denial of what is being lost, like nonverbal information which often reveals more than the words. And then there is the artificial change in voice tone due to the technology. I remember having a sense of how a patient was doing after the tone of the first words in a session. I don’t sense that now on Zoom.

Interestingly, some groups are reporting that they haven’t experienced much loss during the pandemic, especially if they are used to staying home. These tend to be our very own patients. They include those with schizophrenia and some with clinical depression. Some of them wonder if they can teach “normals” something about adjusting to physical distancing and aloneness. Maybe one benefit of social distancing is that we will be more empathic to our patients, but our long-term goal is not to normalize staying home, not for them, nor us.

The late psychiatrist Elisabeth Kubler Ross became renowned for showing one way to grieve successfully. No wonder the first stage is called denial. She knew that the tendency is not to want to process the loss. Perhaps that denial is one of the causes of people starting to flaunt the stay-at-home guidelines and demand liberation. Once getting through that denial, then processing anger, bargaining, depression and acceptance in one’s own individual way goes a long way to resolve the grief.

You may also remember a phrase from an oil filter commercial in the 1970s and ’80s. It was “You can pay me now or later,” meaning that if you didn’t pay for a good filter when you need it for regular maintenance, then you would pay much more when your car broke down. The same may often be true with grieving. It is good maintenance for our minds.

So take the time to have a good cry now if you haven’t already. And even if you have, a booster cry shot of tears is indicated. If the tears don’t come readily, prompt them by listening to some music that usually makes you sad or watch a sad movie. Perhaps other personal losses, or the anniversaries of other social tragedies will open the spigot.

To open our country successfully will take more than just fulfilling economic and medical needs. It will also take filling a psychological need so that our hearts can be reconciled to its feast of losses.

No long list today. Instead, the list of what we need to do has just one item:

Normalize grief for the pandemic. Both adults and kids. Doctor’s orders!

***

“When I look behind,
As I am compelled to look
Before I can gather strength
To proceed on my journey, . . .”